This narrative review evaluates the current role of interventional radiology in the diagnosis and treatment of parathyroid disorders. In patients with biochemically confirmed hyperparathyroidism but inconclusive or discordant preoperative localization imaging, image-guided interventions can help establish a diagnosis that can alter management. This review outlines the current diagnostic and therapeutic modalities for the study of parathyroid pathology from the interventional radiologist’s perspective, highlighting novel techniques and their growing clinical adoption. The combination of ultrasound-guided fine-needle aspiration biopsy and measurement of parathyroid hormone (PTH) in the needle washout fluid can improve diagnostic specificity by providing biochemical evidence of parathyroid tissue. This is particularly useful for lesions that are difficult to differentiate from thyroid nodules or cervical lymph nodes based solely on imaging characteristics. Despite this, no widely accepted cut-off washout PTH level has yet been established. Due to the differences in assay techniques and laboratory procedures, results should be interpreted in conjunction with clinical findings and concomitant biochemical parameters. Ultrasound-guided thermal ablation techniques, especially radiofrequency and microwave ablation, have recently been reported as minimally invasive alternatives or adjuvants to surgery in appropriately selected patients. Evidence supporting parathyroid embolization is limited, but it may be considered a potential salvage option for persistent or recurrent disease. Given that most of the current evidence is derived from retrospective case series, multicenter prospective studies for technical standardization and long-term outcomes evaluation are clearly needed.

Background/Objectives: Drug-coated balloons (DCBs) deliver paclitaxel to the vessel wall and leave nothing behind, which makes them mechanistically appealing here, yet head-to-head data confined to the isolated popliteal/SFA segment are still scarce. We directly compared 12-month hemodynamic, symptomatic, and patency loss outcomes between DCB and plain old balloon angioplasty (POBA) in this anatomical setting. Methods: We retrospectively reviewed 401 consecutive endovascular procedures performed at a single center between January 2021 and December 2024 for isolated popliteal and/or SFA disease, comprising 179 DCB and 222 POBA cases. 12-month endpoints of composite clinical success, asymptomatic recovery, and composite patency loss were analyzed. The composite patency loss endpoint was further fitted to a multivariable logistic regression with baseline ABI, baseline Rutherford category, lesion length, and total occlusion as covariates. The composite patency loss endpoint was further fitted to a multivariable logistic regression with baseline ABI, baseline Rutherford category, lesion length, and total occlusion as covariates, designated as the principal effect estimate. Kaplan–Meier cumulative incidence plots are presented descriptively only. Results: The study population comprised 401 patients (mean age 68.4 ± 10.6 years; 316 male [78.8%]), with 179 in the DCB arm (mean age 65.3 ± 10.5 years; 80.4% male) and 222 in the POBA arm (mean age 71.0 ± 9.8 years; 77.4% male). DCB-treated lesions started out more advanced: longer (94.5 ± 48.2 vs. 82.7 ± 43.3 mm; p = 0.010), more often totally occluded (39.7% vs. 19.4%; p < 0.001), and weighted toward TASC II C/D (p < 0.001). Mean ABI improved by +0.27 in both arms, with no detectable between-arm difference (p = 0.860; within-arm p < 0.001 in each). Asymptomatic recovery at 12 months was more common after DCB (62.0% vs. 51.4%; p = 0.033; OR 1.55, 95% CI 1.04–2.31), and composite patency loss was roughly halved (6.7% vs. 12.6%; p = 0.050; OR 0.50, 95% CI 0.25–1.01). Documented TLR (4.5% vs. 7.2%; p = 0.251) and composite clinical success (86.6% vs. 82.4%; p = 0.255) did not reach significance. Conclusions: Across 401 real-world procedures in isolated popliteal and/or SFA disease, mean ABI gain was identical between arms, yet DCB delivered measurably more complete symptomatic recovery and a near-significant halving of composite patency loss at 12 months, with both signals robust to multivariable adjustment. In this real-world setting, DCB was associated with more complete symptomatic recovery and a numerically lower composite patency loss rate; these findings are hypothesis-generating and require confirmation in adequately powered randomized trials.

Background: Despite not being the primary choice for vascular access in hemodialysis patients, permanent tunneled catheters are commonly utilized but exhibit elevated rates of complications and dysfunction. This study retrospectively compares the dysfunction durations of symmetric and asymmetric-tipped permanent hemodialysis catheters. Materials and Methods: A total of 307 patients who underwent the placement of either symmetric or asymmetric-tipped permanent tunneled catheters at our interventional radiology clinic between 2021 and 2023 were included. The study aimed to examine the dysfunction rates associated with each type of catheter. Results: Among the included patients, 157 were male (51.1%), and 150 were female (48.9%), with an average age of 65.2±12.2 years. The catheters were predominantly placed in the right jugular in 242 patients (78.8%), followed by the left jugular in 59 patients (19.2%), and femoral placement in 6 patients (2%). Symmetric-tipped catheters were employed in 161 patients (52.4%), while asymmetric-tipped catheters were utilized in 146 patients (47.6%). During follow-up, the catheter dysfunction rate was significantly higher in split-tip catheters than in symmetrical-tip catheters (P< 0.0001). Conclusion: The study revealed a statistically significant increase in catheter dysfunction for the asymmetric-tipped catheter type.

Percutaneous renal biopsy is essential for diagnosing kidney disease, yet the optimal technical approach remains debated. This study aimed to compare coaxi

Background/Objectives: Brain death determination in children is clinically challenging. When standard clinical examination cannot be completed or reliably interpreted, ancillary testing is required—yet many established methods depend on infrastructure or patient transport that may not be feasible in critically ill pediatric patients. Orbital ultrasonography is bedside-applicable and non-invasive, but remains poorly characterized in children. Methods: We conducted a single-center retrospective study of 28 pediatric patients evaluated for suspected brain death between January 2021 and February 2025. Patients were classified as brain death-positive [BD(+), n = 20] or brain death-negative [BD(−), n = 8] based on clinical criteria independent of imaging findings. Orbital color Doppler parameters (ophthalmic artery, central retinal artery, posterior ciliary artery) and optic nerve sheath diameter (ONSD) were measured under a standardized protocol by a single experienced operator. Ophthalmic artery resistive index (OA-RI) was defined a priori as the primary outcome; ONSD was the secondary outcome. Group comparisons used the Mann–Whitney U test with Cliff’s delta effect sizes; false discovery rate correction was applied to secondary and exploratory comparisons. ROC analyses were performed to assess discriminative performance. The study was reported in accordance with the STARD 2015 guidelines for diagnostic accuracy research. Results: OA-RI was markedly higher in BD(+) patients (0.84 [IQR 0.80–0.90] vs. 0.65 [0.58–0.69]; p < 0.001; δ = 0.975). ROC analysis yielded an AUC of 0.99 (95% CI: 0.96–1.00); at a cut-off of ≥0.77, sensitivity was 95.0% and specificity 100.0%. ONSD also differed significantly between groups (4.75 [4.15–5.08] mm vs. 3.90 [3.40–4.15] mm; p = 0.012; δ = 0.619; AUC = 0.81, 95% CI: 0.62–1.00; cut-off ≥ 4.2 mm; sensitivity and specificity both 75.0%). Across all three orbital vessels, end-diastolic velocity was consistently reduced and resistive indices elevated in BD(+) patients. Systolic velocities did not differ meaningfully between groups. Cut-off values represent cohort-specific statistical optima and should be interpreted as exploratory. Conclusions: Orbital Doppler ultrasonography demonstrates a coherent high-resistance hemodynamic pattern in pediatric brain death. OA-RI showed strong discriminative performance and may serve as a useful bedside adjunct in selected cases where ancillary testing is indicated. ONSD provides complementary anatomical evidence. These findings are exploratory and require prospective validation in larger, multicenter pediatric cohorts.